Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs), Exams of Nursing

Download Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) and more Exams Nursing in PDF only on Docsity! Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) Frank owned a home that was destroyed by a hurricane. Both ABC and XYZ Banks were listed as additional interests on his homeowner policy. The insurance company will make a payment to: A. The first mortgagee, ABC B. The Insured C. Jointly to ABC and XYZ D. All listed interests - correct answer ✅D. All listed interests Remember that the insurer is not responsible to know the degrees of interest. In the event of a loss, one payment is made by the insurer and it is up to the additional interests on working out their share. The __________ states that when there is an unbroken connection between an occurrence and damage that grows out of the occurrence, then the resultant damage is all a part of the occurrence. A. Doctrine of Proximate Cause B. Doctrine of Perils & Hazards C. Insurance Policy Handbook D. Doctrine of Property Insurance - correct answer ✅A. Doctrine of Proximate Cause For example, if a property insurance policy covers the peril of fire but further damage is caused by smoke, water used to extinguish, and the process of moving Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) property away - fire is considered to be the *proximate cause* of all of the damage. Insurance applies separately to each insured as if other insureds did not exist. This is defined as: A. Severability B. Conditional C. Warranty D. None of the above - correct answer ✅A. Severability Property insurance policies usually contain a(n) __________ clause, stating the insured cannot dump damaged property on the insurer and demand its full value: A. Pro Rata B. Abandonment C. Liberalization D. All of the above - correct answer ✅B. Abandonment A(n) __________ is one wherein economic loss would be suffered from an adverse happening to the subject: A. Conditional Contract Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) C. Indemnity Contract D. All of the Above - correct answer ✅A. Conditional Contract "may be conditioned" Which of the following is not one of the "Thresholds" in the "No-Fault" law? A. Death of the Insured B. Temporary Injury of the Insured C. A permanent loss of a bodily function D. Permanent scarring on the face of the insured - correct answer ✅B. Temporary Injury of the Insured Also included: permanent injury other than scarring and disfigurement Under Mechanical Breakdown Coverage, new cars are eligible for service up to: A. 36 Months/36,000 Miles B. 24 Months/36,000 Miles C. 12,000 Months/12,000 Miles D. 12 Months/36,000 Miles - correct answer ✅A. 36 Months/36,000 Miles Used vehicles: 12 Months/12,000 Miles Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) If financial responsibility doesn't exist at the time of an accident, which of the following things must happen to avoid penalties? A. The legally valid claims of others must be satisfied (up to 10/20/10) B. The owner and operator must provide certification of future responsibility for future accidents C. Both A & B D. None of the Above - correct answer ✅C. Both A & B As to required proof for future accidents by purchase of auto liability insurance, the insurer must make a filing (Form SR-22) certifying that coverage is in effect, and this certification must remain on file for __________ years: A. 1 B. 3 C. 4 D. 2 - correct answer ✅B. 3 The Business Automobile Policy includes all of the following coverage forms except: A. The Garage Coverage Form B. The Trailer Interchange Coverage Form Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) C. The Truckers Coverage Form D. The Business Auto Coverage Form - correct answer ✅B. The Trailer Interchange Coverage Form Personal Injury Protection, or PIP, has a __________ per person, per accident limit. A. 10,000 B. 20,000 C. 1,000 D. Depends on the damaged property - correct answer ✅A. 10,000 Used to insure businesses engaged in selling, servicing, repairing, parking or storing automobiles: A. Servicing Coverage Form B. Garage Coverage Form C. Truckers Coverage Form D. None of the Above - correct answer ✅B. Garage Coverage Form The following examples are referred to as __________ liability limits: 25/50/25 or 10/20/10. Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) C. Personal Property D. Dwelling - correct answer ✅A. Other Structures Examples include sheds, fences, pool houses, detached car ports, etc. A lender has an insurable interest in a home and finds protection in the: A. Loss Payee Clause B. Mortgagee Clause C. Lender Clause D. Additional Insured Clause - correct answer ✅B. Mortgagee Clause Mortgagee - Homeowner's policy Loss Payee - Automobile policy Which of the following forms is "all-risk" on the dwelling policy? A. DP-1, or the Basic Form B. DP-2, or the Broad C. DP-3, or the Special Form D. None of the Above - correct answer ✅C. DP-3, or the Special Form Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) When the basic liability limits provided by the policy are insufficient for an insureds needs, two coverage forms are used to provide the additional amounts of coverage: A. Excess Liability B. Umbrella C. Both A & B D. None of the Above - correct answer ✅C. Both A & B Which of the following is not covered under Coverage C, Personal Property? A. A fire breaks out in the residence and an overnight guest loses his clothes in the fire B. A fish dies because he has been left alone for a week without food C. The insureds daughters tennis racket is stolen from her locker D. The insureds suitcase and clothing, valued at $1,500, are stolen from his hotel - correct answer ✅B. A fish dies because he has been left alone for a week without food Animals are listed as an "exclusion" under a Homeowner's policy. All of the following are eligible for a Homeowner's Policy, except? A. An apartment tenant Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) B. A condominium owner C. Four-family dwelling owner-occupant D. A business condo owned by a local insurance company - correct answer ✅D. A business condo owned by a local insurance company Commercial property is not eligible for a Homeowner's policy. Which of the following are characteristics of Homeowner's Insurance? A. Protects against economic loss to residences and household property and legal liabilities B. Owner-occupants of 1-4 family dwellings C. Renters who maintain residential occupancy in any type of building D. All of the Above - correct answer ✅D. All of the Above Also included: personal, non-business risk, no more than 2 roomers/boarders, condominium unit owners and cooperative apartment occupants Jeremy owns a home that is recently damaged due to a hurricane. The repair estimate is averaged at $25,000 and Jeremy decides to stay in a hotel because most of the damage is to his bedroom and kitchen. Under a Homeowner's Policy, what coverage will pay for the hotel room bill? A. Fair Rental Value Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) This, along with Condo Unit Owners Form, is located under Condo Coverage. Sometimes referred to as commercial fire and allied lines, this is the form of insurance that covers direct and indirect losses related to properties other than one-to-four family dwellings and farm properties: A. Business Property Insurance B. Building Property Insurance C. Commercial Property Insurance D. None of the Above - correct answer ✅C. Commercial Property Insurance (the question is the definition for this term) Under Commercial Property Policies, Florida law requires an insurer to give the insured at least __________days advance written notice of non-renewal. A. 25 B. 90 C. 45 D. None of the Above - correct answer ✅C. 45 Also, notice must state reasons the policy is not to be renewed. Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) When a business's personal property values fluctuate, a single, fixed amount of insurance could produce either over- or under-insurance at any given time. With this option, the limit of coverage is set at an amount somewhat higher than expected peak values. A. Value Reporting B. Replacement Cost C. Agreed Value D. None of the Above - correct answer ✅A. Value Reporting Replacement Cost is incorrect b/c it calculates monetary value of one's personal property Liberalization states, "The insured gets the benefit of any broadened coverage if the company, within __________ days of inception, adopts a form revision that is broader and without increase in premium." A. 10 days B. 55 days C. 65 days D. 45 days - correct answer ✅D. 45 days Used to cover buildings in the course of construction: Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) A. Builders Risk Policy B. Builders Replacement Policy C. Construction Replacement Policy D. None of the Above - correct answer ✅A. Builders Risk Policy Includes: structure being built (including foundations), fixtures and machinery, equipment to service building, owned materials and supplies used for construction. Temporary structures built or assembled on site are also included if not covered by insurance. First developed as an extension of Ocean Marine coverage, to provide coverage for cargo traveling over land, instead of by sea. A. Commercial Inland Marine Coverage B. Personal Inland Marine Coverage C. Ocean Commercial Coverage D. None of the Above - correct answer ✅A. Commercial Inland Marine Coverage Definition: to help identify kinds of risks which are eligible for either Ocean or Inland Marine insurance. Protects against loss of business income that results from damage to covered property from a covered cause of loss. Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) There is __________ coverage for injury, damage or clean-up costs caused by pollutants, subject to minor exceptions: A. 50% B. 10% C. 0% D. A Percentage Ratio - correct answer ✅C. 0% Under a Commercial General Liability Policy, a basic limit of __________ per person applies to Medical Payments: A. $1,000 B. $10,000 C. $2,500 D. $5,000 - correct answer ✅D. $5,000 Payment is for medical, dental, hospital, and funeral services incurred within one year of date of accident to persons who suffer bodily injury by accident 1. on or next to insured's owned or rented premises, or 2. due to insured's operations. The Commercial General Liability __________ identifies the named insured and address, states the policy period and premium and miscellaneous information about the insured, and specifies the limits of coverage that apply. Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) A. Declarations B. Contract C. Policy D. None of the Above - correct answer ✅A. Declarations States the pertinent information of the policy The Nuclear Energy Liability Exclusion endorsement, in general, __________ all hazards related to nuclear energy. A. Includes B. Excludes C. Prohibits D. Summarizes - correct answer ✅B. Excludes Firms involved in Nuclear activities receive protection from special insurer pools organized for that purpose. Toxic wastes escaped from a gas station disposal tank. The insured operator discovers the leak and cleans up the spill. Unfortunately, the waste quickly seeped into the ground and has caused illness among the residents of a neighboring community This is an example of? A. Loss Known Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) B. Known Loss C. Claims-Made D. None of the Above - correct answer ✅B. Known Loss Insurer should have been notified and further investigation of the spill and effective clean-up would have been observed. Applies to BI or PD which occurs during the policy period, regardless of any later time at which a claim is made: A. Occurrence Form B. Claims-Made Form C. Premises and Operations Exposure D. None of the Above - correct answer ✅A. Occurrence Form vs. Claims-Made: applies only to BI or PD occurring on or after retroactive date for which claim is received/recorded during policy period Applies only to a BI or PD which occurs on or after the retroactive date, and for which the claim is received or recorded by an insured or the company during the policy period: A. Occurrence B. Claims-Made Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) Under workers compensations, a rate is charged for every __________ of payroll to employees. A. $100 B. $1,000 C. $10 D. $500 - correct answer ✅A. $100 The National Council on Compensation Insurance enforces this rating. Under Workers Compensation, Part Four Your Duties if Injuries Occur, an employer is required to: A. Provide the names/addresses of injured persons and witnesses B. Promptly provide any legal papers C. Cooperate and assist as insurer requests D. All of the Above - correct answer ✅D. All of the Above Also included: immediate contact with insurer, providing immediate medical or other services, do nothing to interfere with insured's right of recovery, make no voluntary payments or assume any obligation except at employer's own cost. Under Workers Compensation, Employers Liability includes: A. Claims by others for the liabilities to insureds employees Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) B. Claims by relatives of injured employees for consequential damages C. Claims made by employees that are not subject to Workers Comp Laws D. All of the Above - correct answer ✅D. All of the Above Samantha eats uncooked chicken at a local barbecue joint and becomes violently ill. Which of the following workers compensation benefits would pay for this occurrence? A. A products and completed operations form B. A premises and operations form C. An owners and contractors protective liability form D. None of the Above - correct answer ✅D. None of the Above Samantha is not an employee of the barbecue joint; Workers Comp does not apply. An optional alternative providing for adjustment of premium after expiration, based on a guaranteed basic premium to the insurer to which is added the actual losses incurred by the insured. This is defined as: A. Cost-Plus Rating Plan B. Experience Rating Plan C. Retrospective Rating Plan Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) D. None of the Above - correct answer ✅C. Retrospective Rating Plan Often referred to as Cost-Plus Programs Under Employer's Liability, the minimum limits of liability are: A. 100/100/500 B. 100/500/1000 C. 500/100/500 D. 100/500 - correct answer ✅A. 100/100/500 $100,000 for all claims in each accident $100,000 per employee for disease $500,000 for all disease claims Under Inside The Premises - Robbery or Safe Burglary of Personal Property, a special limit of __________ per occurrence applies to articles whose principal value is precious metals, precious or semiprecious stones, pearls or furs, and to the physical or intrinsic value of manuscripts, drawings or records: A. $1,000 B. $2,000 C. $4,000 D. $5,000 - correct answer ✅D. $5,000 Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) D. All of the Above - correct answer ✅D. All of the Above Unless the loss is specifically excluded or limited Provides for loss of money and securities outside the premises in the care, custody and control of a messenger or armored car service resulting from theft, disappearance or destruction. This is defined as: A. Inside the Premises B. Outside the Premises C. Care, Custody, & Control D. None of the Above - correct answer ✅B. Outside the Premises Also covers robbery of other property under the circumstances. Taking or attempted taking of property from within a locked safe or vault, by unlawful entry, with visible marks of forcible entry, or taking of the safe or vault from inside the premises. This is defined as: A. Safe Burglary B. Inside the Premises C. Custodial Burglary D. None of the Above - correct answer ✅A. Safe Burglary Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) Exclusions: accounting errors, giving/surrendering property, voluntarily parting, fire (except damage to safe/vault), vandalism, transferring property to someone based on unauthorized instructions or from threat to harm Covers for all types of property, when surrendered away from the premises as a result of a threat to do bodily harm to the insured or an employee, or to a relative or invitee of either, who is (or allegedly is) being held captive. This is defined as: A. Extortion B. Surrendered Property C. Client's Property D. None of the Above - correct answer ✅A. Extortion Also triggered by threats to damage the premises or property within the premises. Employee Theft Coverage may be written in the following ways: A. Scheduled Persons Coverage B. Scheduled Position Coverage C. Blanket Coverage D. All May Apply - correct answer ✅D. All May Apply Employee Theft may be written in three ways. Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) Which of the following are NOT a type of bond? A. Contract B. Fiduciary C. Court D. Apprentice - correct answer ✅D. Apprentice Contract - fulfill obligation Fiduciary - make good to court for any deficiencies found in performance Court - protect opposing party from loss Which of the following are characteristics of a License Bond? A. To guarantee the licensee will act according to laws B. Protect public from unfair business practice C. Proper collection and payment of taxes D. All of the Above - correct answer ✅D. All of the Above Guarantees the performance between the principle and the obligee: A. Principal B. Obligee C. Surety Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) C. Surety D. All of the Above - correct answer ✅D. All of the Above Principal - undertakes to perform/fulfill Obligee - guaranteed principal will perform Surety - guarantees performance *Indemnitor - may act as additional party; agrees to reimburse surety for any loss This type of bond covers streets, sidealks, sewers, etc.: A. Sidewalk B. Subdivision C. Supply D. None of the Above - correct answer ✅B. Subdivision Falls under Maintenance Bond When a person has lost stock certificates, bonds or similar instruments, a bond is generally required by the issuing company to reissue the document. This is known as a: A. Public Official Bond B. Lost Instrument Bond Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) C. Public Instrument Bond D. None of the Above - correct answer ✅B. Lost Instrument Bond Also guarantees to save issuer from any loss growing out of lost instrument A __________ is a selected group of hospitals and medical practitioners in a given area who have joined together in an effort to reduce medical costs. A. HMO B. Major Medical Insurance C. Coinsurance D. PPO - correct answer ✅D. PPO Most plans provide that emergency treatment will be paid even if treated party does not go to service provider on approved list. Define the coverage that pays a flat amount per day for hospitalization, regardless of expenses or other insurance: A. Hospitilization B. Hospital Indemnity C. Hospital Services D. All of the Above - correct answer ✅B. Hospital Indemnity Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) This optional provision states that if the insured becomes totally disabled, premiums are waived but the coverage remains in force: A. Waiver of Subrogation B. Waiver of Premium C. Waiver of Value D. None of the Above - correct answer ✅B. Waiver of Premium "premiums are waived" Provides coverage for expenses, including loss of income, arising from an accident. This is defined as? A. Accident Insurance B. Hospitilization C. Hospital Pay D. None of the Above - correct answer ✅A. Accident Insurance Typical exclusions would be: hernia, war, disease and bacterial infections, suicide attempts, air travel injuries, accidents while committing felony, accidents while under the influence Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) A. Hospitalization Expense B. Hospital Indemnity C. Accident Policy D. All of the Above - correct answer ✅A. Hospitalization Expense Associated with a daily limit, not to exceed specified maximum A(n) __________ provides comprehensive health services to its members for a prepaid fixed fee, equivalent to an insurance premium. A. HMO B. PPO C. Major Medical Plan D. All of the Above - correct answer ✅A. HMO Referred to as an emerging and increasingly important non-insurance alternative to dealing with risk of health care costs Established in 1973, this association was created for applicants who are unable to obtain insurance in the private market: A. FWCJUA B. FWUA C. Citizens Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) D. FRPCJUA E. FAJUA - correct answer ✅E. FAJUA In 2002, the Florida Residential Property and Casualty Joint Underwriting Association (FRPCJUA) and the Florida Windstorm Joint Underwriting Association (FWUA), were combined to create: A. FWCJUA B. FWUA C. Citizens D. FRPCJUA E. FAJUA - correct answer ✅C. Citizens Passed during a legislative session in 1993, this association was created for employers who cannot obtain workers compensation insurance in the private market: A. FWCJUA B. FWUA C. Citizens D. FRPCJUA E. FAJUA - correct answer ✅A. FWCJUA Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) A General Lines Agent instructs a licensed Customer Representative 4-40 to thoroughly cover the details of a new life insurance product with every Homeowner customer who calls or visits the office. The agent provides training on the new product. Although the Customer Representative does not have a Life License, he or she feels comfortable with the training and does as requested. Which of the following is true? A. This practice is acceptable if done in the office under supervision of General Lines Agent B. This practice is acceptable because adequate training and product knowledge was provided C. This practice is unacceptable and may result in the suspension or revocation of the Customer Representative's license D. This practice is only acceptable if the product training was certified by the Life Insurance Company - correct answer ✅C. This practice is unacceptable and may result in the suspension or revocation of the Customer Representative's license Unlike a Customer Representative, a General Lines Claim Adjuster need not be appointed with the Department of Financial Services. A. True B. False - correct answer ✅B. False Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) B. False - correct answer ✅A. True A General Lines Claim Adjuster is required to obtain the same number of Continuing Education hours as a licensed Customer Service Representative. A. True B. False - correct answer ✅B. False An Insurance Company which is formed under the laws of the State of Illinois, and has its Home Office there, is considered a: A. US Domestic Company B. Foreign Company C. Alien Company D. Unadmitted Company - correct answer ✅B. Foreign Company Domestic: this state (FL) Foreign: other state (still in US) Alien: elsewhere One who is involved in the investigation, adjustment, negotiation and/or trial preparations of claims arising under insurance policies is defined as: A. Insurance Agent Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) B. General Lines Agent C. Claims Adjuster D. All of the Above - correct answer ✅C. Claims Adjuster Commonly referred to as claims auditor Establishing a dollar value on a claim is defined as: A. Negotiation B. Evaluation C. Adjusting D. None of the Above - correct answer ✅B. Evaluation For bodily injury and uninsured motorist claims, a settlement range will be set rather than a single dollar amount Damaged property that may be retrieved, reconditioned and sold to reduce an insured loss is defined as: A. Junk B. Salvage C. Covered Property D. Peril - correct answer ✅B. Salvage Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) Efficient disposal of salvage reduces amount of loss to either insured or insurer The voluntary or intentional relinquishment of a known right is defined as a(n): A. Waiver B. Estoppel C. Avoidance of Performance D. None of the Above - correct answer ✅A. Waiver The law recognizes two types: express and implied. The principle of utmost good faith on which an insurance contract is based places serious responsibilities on the claims adjuster in regards to: A. Conduct B. Work Habits C. Claim Handling Activites D. All of the Above - correct answer ✅D. All of the Above The adjusters basic activities in claims handling are: A. Investigation B. Evaluation Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) B. Public Adjuster C. Bureau Adjuster D. Independent Adjuster - correct answer ✅D. Independent Adjuster The adjuster's investigation may include all of the following except: A. Verification of Bills and Estimates B. Photographs C. Witness Canvasses D. Policy Cancellation - correct answer ✅D. Policy Cancellation The assertion of an alleged legal right against an insurer, which carries with it a demand for appropriate relief, is defined as: A. Adjustment B. Summons C. Claim D. None of the Above - correct answer ✅C. Claim Relieving the financial burden on the claimant by making certain payments to the claimant even before the claim can be negotiated is defined as: Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) A. Advanced Payment B. Full Release Settlement C. Non-Advanced Payment D. Scheduled Payment - correct answer ✅A. Advanced Payment The process of disposing of an insurance claim is defined as: A. Adjusting B. Claims Management C. Adjustment D. None of the Above - correct answer ✅A. Adjusting Also "the negotiation period that results in an agreement" All of the following are requirements for the "Code of Ethics," except: A. Adjusters should not give legal advice B. Adjusters may negotiate with a claimant who is represented by an attorney C. A witness who requests a copy of a statement given must be provided with one D. Adjusters will keep an unprejudiced and open mind - correct answer ✅B. Adjusters may negotiate with a claimant who is represented by an attorney Adjusters MAY NOT. Bad, adjuster, bad! Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) A written statement given by the insured to the insurer acknowledging that money received in the settlement of damages is received, not as a final payment, but as an advance pending an outcome of a claim against the person responsible for the damage. This is defined as a(n): A. Loan Receipt B. Subrogation Loan C. Full Release Statement D. Partial Release Statement - correct answer ✅A. Loan Receipt Enables insurer to bring an action for recovery against a third party Duties and functions of the Department of Financial Services include all of the following except: A. Approve the issuance of licenses B. Rating and underwriting rules C. Claims Supervision D. Investigate charges of unethical behavoir - correct answer ✅B. Rating and underwriting rules Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) The District of Columbia and any state or territory of the United States in which an insurance agent maintains his or her principal place of residence or principal place of business and is licensed to act as an insurance agent. This is defined as: A. Business Territory B. Home Territory C. Home State D. None of the Above - correct answer ✅C. Home State Any material which is or may have been a motor vehicle or mobile home, which is inoperable and which material is in such condition that its highest or primary value is either in its sale or transfer as scrap metal or for its component parts, or a combination of the two. This is defined as: A. Junk B. Derelict C. Major Component Parts D. None of the Above - correct answer ✅B. Derelict An individual appointed by a general lines or agency to assist that agent or agency in transacting the business of insurance from the office of that agent or agency is defined as: A. Customer Representative Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) B. General Lines Agent C. Adjuster D. None of the Above - correct answer ✅A. Customer Representative (4-40 license) The authority given by an insurer or employer to a licensee to transact insurance or adjust claims on behalf of an insurer or employer is defined as: A. Appointment B. Express Authority C. Registered D. Certificate of Authority - correct answer ✅A. Appointment Licensees are given authority through the appointment process The Department may issue a nonrenewable temporary license authorizing the appointment of a general lines insurance agent, life agent, or an industrial fire or burglary agent, for a period not to exceed: A. 1 Year B. 6 Weeks C. 1 Month D. 6 Months - correct answer ✅D. 6 Months Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) How many continuing education hours must an insurance adjuster complete every 2 years? A. 12 B. 20 C. 24 D. 14 - correct answer ✅C. 24 Which of the following are considered unfair methods of competition and unfair or deceptive acts or practices: A. False Statements B. Unfair Discrimination C. Unlawful Rebates D. All of the Above - correct answer ✅D. All of the Above A customer representative appointed by a general lines agent or agency in transacting only the business of private passenger motor vehicle insurance from the office of that agent or agency is defined as: A. Automobile Agent B. Automobile Representative Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) D. General Lines Agent - correct answer ✅D. General Lines Agent An agent representing a health maintenance organization, or as to health insurance only, an insurer transacting health insurance is defined as a(n): A. Health Agent B. Health Representative C. HMO Agent D. None of the Above - correct answer ✅A. Health Agent An applicant for a temporary license must be: A. A natural person at least 18 years of age B. A US citizen or legal alien who possesses work authorization C. Both A & B D. None of the Above - correct answer ✅C. Both A & B One who is duly authorized by a subsisting certificate of authority issued by the department to transact insurance in this state. This is defined as a(n): A. Unauthorized B. Certified Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) C. Domiciled Insurer D. Authorized - correct answer ✅D. Authorized Actual Cash Value - correct answer ✅Replacement cost minus depreciation Subrogation - correct answer ✅When an insured has a right to collect damages from another party but elects to claim damages under his/her insurance policy; rights transfer to the insurer Loss Payee Clause - correct answer ✅Provides, in event of payment being made under the policy in relation to insured risk, that payment will be made to a third party rather than the beneficiary Mortgagee Clause - correct answer ✅Protects a lender who has an insurable interest in a home Grants special protection for the interest of a mortgage named in the policy; setting up a separate content between insurer and mortgagee Liability - correct answer ✅Negligence of the insured Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) Other Structures - correct answer ✅Homeowner's Policy, covers items not permanently attached to main dwelling (shed, fence, etc.) Commercial Inland Marine - correct answer ✅Identifies risks which are eligible for either ocean or inland marine insurance Developed as extension to Ocean Marine coverage to provide coverage for cargo traveling over land instead of by sea Umbrella Policy - correct answer ✅Covers much higher limit and goes above/beyond claims directly relating to home and auto; protects assets from unforeseen events Known Loss - correct answer ✅Prevents insured from coverage if insured knew the loss was probable at time of contract Commercial Property Insurance - correct answer ✅Sometimes referred to as Commercial Fire and Allied Lines; Covers direct and indirect losses related to properties other than 1-4 family dwelling and farm properties Value Reporting - correct answer ✅Limit of coverage set at an amount higher than expected peak values Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) Estoppel - correct answer ✅An equitable principle to the effect that if one intentionally or unintentionally creates the impression that a certain fact exists, an innocent party relies on that impression and is damaged as a result, the guilty party may be legally prohibited (estopped) from asserting that the fact does not exist. Junk - correct answer ✅Any material which is or may have been a motor vehicle or mobile home, with or without all component parts, which is inoperable and which material is in such condition that its highest or primary value is either in its sale or transfer as scrap metal Salvage - correct answer ✅Damaged property that may be retrieved, reconditioned and sold to reduce an insured loss. Motor vehicle or mobile home is a total loss Appointment - correct answer ✅Authority given by an insurer or employer to a licensee to transact insurance or adjust claims on their behalf Derelict - correct answer ✅Material which is or may have been a motor vehicle or mobile home, with or without all component parts, which is inoperable and which material is in such condition that its highest or primary value is either in its sale or transfer as scrap metal or component parts or both Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) Implied Waiver - correct answer ✅May result from some act of neglect on part of the adjuster Express Waiver - correct answer ✅Occurs when insurer or its representative knowingly gives up a known right under insurance contract Mechanical Breakdown Coverage - correct answer ✅Covers repairs to mechanical parts of your vehicle that break; even covers in events not related to an accident Identify examples of peril. - correct answer ✅Fire, windstorm, flood after hurricane, etc. (something that causes a loss) How long does one have to notify the Department of Financial Services for a name and/or address change? - correct answer ✅30 days What is the coinsurance clause and how might it apply to a given scenario? - correct answer ✅A coinsurance clause on a property policy requires the policyholder to carry, at minimum, a specified percent of the dwelling's replacement cost. Failure results in monetary penalty. Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) Almost without exception, the percentage is 80% in coinsurance clauses of homeowner policies - this means the insured should carry 80% of replacement cost if they don't want to be penalized at the time of loss. What are the minimum requirements for the Financial Responsibility Law? (there are two) - correct answer ✅1. legal valid claims of others must be satisfied up to the 10/20/10 requirements 2. owner/operator must provide certification of financial responsibility for future accidents What is PIP and how may it apply to a given scenario? - correct answer ✅Personal Injury Protection with limit of $10,000 per person, per accident If Jeremy has a not-at-fault accident and he has PIP with a $1000 deductible, he can expect PIP to pay $1,600 of his $3,000 medical bill. (3,000 - 1,000 = 2,000 x .80 = 1,600) What is the difference between PIP and Workers Compensation? Which one is excess? - correct answer ✅PIP is primary against all other forms of medical and disability insurance coverage. Florida courts have held PIP is excess over Workers Comp. To eliminate duplicate recoveries, the law prohibits persons who have received PIP from recovering same amounts from others in legal liability actions. Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) -renters who maintain residential occupancy in any type of building -other structures (not permanently attached) What are the benefits under the Workers Compensation Law? - correct answer ✅- Medical Expenses: needed medical treatment with no dollar limit -Disability Benefits: compensation for wage loss -Death Benefits: if death results within one year of accident or, if it follow continuous disability, within five years after the accident What are the requirements for continuing education for a 6-20 license? - correct answer ✅A licensed General Lines Claims Adjuster is required to complete 24 hours of education every 2 years. Who might have an insurable interest in a property? - correct answer ✅Anyone who would suffer an economic loss from an adverse happening to the property What do the Declarations of a policy outline? - correct answer ✅The declarations identifies the named insured and address, states the policy period and premium and miscellaneous information about the insured, and specifies the limits of coverage that apply Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) Which parties are associated with a bond? - correct answer ✅-Principal: one who undertakes to perform, fulfill a contract, or meet an obligation -Obligee: one who is guaranteed that the principal will perform -Surety (Bonding Company): guarantees performance -Indemnitor: may act as additional party at times; agrees to reimburse the surety for any loss it may suffer from having bonded the principal What are the features of Major Medical Insurance? - correct answer ✅Major Medical Insurance is intended to afford protection against catastrophic losses. Some forms are designated to supplement basic hospital/surgical policies; others intend to provide both basic and catastrophic coverage These policies are characterized by a deductible, high maximum limit, and percentage participation or coinsurance. It may contain internal limits for hospital daily room charge and surgical services. What associations make up Citizens Property and Insurance? - correct answer ✅Florida Residential Property and Casualty Joint Underwriting Association (FRPCJUA) and Florida Windstorm Joint Underwriting Association (FWUA) Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) What are the characteristics of a Personal Automobile Policy Declaration page? - correct answer ✅Liability (bodily injury), property damage, uninsured motorist, medical payments, PIP, collision deductible, comprehensive deductible, towing coverage, and rental coverage What are some examples of transacting insurance? - correct answer ✅1. solicitation and inducement 2. preliminary negotiations 3. effectuation of a contract of insurance 4. transaction of matters subsequent to effectuation of contract of insurance 5. mailing or otherwise delivering written solicitation to any person in this state by an insurer or any person acting on their behalf for fee or compensation What is the website for the Florida Department of Financial Services? - correct answer ✅www.myfloridacfo.com What are the thresholds of the No-Fault Law? - correct answer ✅(1) Significant and permanent loss of a bodily function, or (2) Permanent injury other than scarring and disfigurement, or (3) Significant and permanent scarring or disfigurement, or (4) Death. Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) 7. Failure to inform Department of Financial Services, within 30 days, after pleading guilty or no contest to a felony. Compare/contrast different types of adjusters. - correct answer ✅1. Independent Adjuster - self-employed and not affiliated with either insurers or bureaus 2. Company/Staff Adjuster - salaried employee under supervision of home, branch, regional claims department of insurers 3. Public Adjuster - represents the financial interests of the insured named in the policy 4. Claims Adjuster - one who is involved in the investigation, adjustment, negotiation and/or trial preparations of claims arising under insurance policies 5. Bureau Adjuster - agent of adjustment bureau which serves multiple company clients *Independent and Bureau are both "Fee Adjusters" What is an Insurance Contract? - correct answer ✅Insurance is a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies What are the components that make up the investigation process? - correct answer ✅Inquiry, verification, comparison Florida Claims Adjuster Exam Questions and Answers Latest Update 2023(206 Qs) What are the Code of Ethics for adjusters? - correct answer ✅Formal rules which impact on adjuster practices 1. Adjusters may not directly negotiate with a claimant who is represented by an attorney. 2. In interviewing witnesses, adjusters must avoid any actions tending to induce a suppression or deviation from the truth. A witness who requests a copy of a statement given must be provided with a copy. 3. Adjusters shall not give legal advice. 4. Adjusters shall not draft special releases; they are permitted only to fill in blanks of forms provided by the insurer. 5. Adjusters will not take advantage of an incapacitated claimant which would be to the detriment of the claimant. 6. Adjusters will not knowingly fail to advise claimants of their rights under contracts and laws of the state. 7. Adjusters will approach all aspects of the process with an unprejudiced and open mind, make truthful and unbiased reports, handle all processes with integrity and accept no remuneration other than that to which there is legal entitlement, and act with diligence and due dispatch in achieving proper disposition of claims. 8. The adjuster must put the duty for fair and honest treatment of the claimant above the adjuster's own interests, in every instance.